NCG500312_complete file-historical_20151228

Weaver, Charles
From: Weaver, Charles
Sent: Monday, December 28, 2015 9:19 AM
To: [e-mail]'
Subject: renewal of NCG500312 / Greystone Concrete
Attachments: NCG50 Final 093015.pdf, Technical Bulletin - NCG500000 2015.doc
Importance:
High
Attached you will find the updated version of NPDES General Permit NCG500000, effective 10/1/2015. Discard any
previous versions of the General Permit and use this version until further notice.
You do not need a reprinted Certificate of Coverage, as the one issued to you in 2010 is still applicable.
Thank you for your patience during the longer -than -expected renewal period.
If you have any questions about this matter, simply reply to this message.
Charles H. Weaver
Environmental Specialist
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919-807-6391
cha rles.weaver(dncdenn oov
(physical address)'512 North Salisbury Street, Raleigh, NC 27604
(mailing address)1617 Mail Service Center, Raleigh, NC 27699-1617
0 �Noshing Compares.,. -
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties.

Weaver, Charles
From: Microsoft Outlook
To: [e-mail]
Sent: Monday, December 28, 2015 9:20 AM
Subject: Relayed: renewal of NCG500312 / Greystone Concrete
Delivery to these recipients or groups is complete, but no delivery notification was sent by the
destination server:
orevstone.contactCabomail.com (oreystone.contactCalomail com)
Subject: renewal of NCG500312 / Greystone Concrete
I
renewal of
NCG500312 / Gr...

Twin
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Coleen H. Sullins, Director
July 23, 2007
Samuel H. Cannady
Greystone Concrete Products, Inc.
P.O. Box 680
Henderson, NC 27536
Subject: Renewal of coverage / General Permit NCG500000
Greystone Concrete Products
Certificate of Coverage NCG500312
Vance County
Dear Permittee:
In accordance with your renewal application [received on January 11, 2007], the Division is renewing
Certificate of Coverage (CoC) NCG500312 to discharge under NCG500000. This CoC is issued pursuant to the
requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated May 9, 1994 [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Raleigh Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit, please contact Jim
McKay [919 733-5083, extension 595 or [e-mail].
Sincerely,
-A 4 �
for Coleen H. Sullins
cc: Central Files
Raleigh Regional Office / Surface Water Protection
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699.1617 QRe
512 North Salisbury Street, Raleigh, North Carolina 27604 NofthCarolina
Phone: [phone] / FAX [phone] / Internet: www.ncwaterquality.org Naturally
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An Equal Opportunity/Affirmative Action Employer —50%f�/�/Recycled/10%PostConsumerPaper L /

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG500000
CERTIFICATE OF COVERAGE NCG500312
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE AND SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
Greystone Concrete Products, Inc.
is hereby authorized to discharge from a facility located at
Greystone Concrete Products
2100 N Garnett Street
Henderson
Vance County
to receiving waters designated as an unnamed tributary to Fox Reservoir in subbasin 30302
of the Tar -Pamlico River Basin in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective August 1, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 23, 2007.
/�� -A 4��
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
NOTICE OF RENEWAL INTENT
Application for renewal of existing coverage under General Permit NCG500000
Existing Certificate of Coverage (CoC): NCG500q�
(Please print or type)
1) Mailing address' of facility owner/operator:
Company Name
Owner Name
Street Address
City
Telephone Number
Email address
State ZIP CodeS
_ _ 0_
` Address to which all permit correspondence should be mailed
2) Location of facility producing discharge:
Facility Name
Facility Contact
Street Address
city ��I/�% il'� State- ZIP Code -P--7 ` /
County
Telephone Number
Email address
3) Description of Discharge:
a) Is the discharge directly to the receiving stream? ❑ Yes No
(If no, submit a site map with the pathway to the potential receiving waters clearly marked. This includes tracing the pathway of the
stone sewer to the discharge point, if the storm sewer is the only viable means of discharge.)
b) Number of discharge outfalls (ditches, pipes, channels, etc. that convey wastewater from the property):
_2
c) What type of wastewater is discharged? Indicate which discharge points, if more than one.
❑ Non -contact cooling water
V Boiler Blowdown
Outfall(s) #:
Outfall (s) #:�
Page 1 of 3

NC:G500000 renewal application
❑ Cooling Tower Blowdown
VICondensate
❑ Other
Outfall (s) #:
Outfall (s) #:
Outfall (a) (s) #:
(Please describe "Other")
d) Volume of discharge per each discharge point (in GPD):
#001: #002: 9422 #003: #004
4) Please check the type of chemical [s] added to the wastewater for treatment, per each separate discharge
point (if applicable, use separate sheet):
❑ Chlorines ❑ Biocides ❑ Corrosion inhibitors El Algaecide ❑ Other
�i None
5) If any box in item (4) above [other than None] was checked, a completed Biocide 101 Form and
manufacturers' information on the additive must be submitted to the following address for approval:
NC DENR / DWQ / Environmental Sciences Section
Aquatic Toxicology Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
6) Is there any type of treatment be' provided to the wastewater before discharge (i.e., retention ponds,
settling ponds, etc.)? ❑Yes No
(If yes, please include design specifics (i.e., design volume, retention time, surface area, etc.) with submittal package. Existing
treatment facilities should be described in detail. )
7) Discharge Frequency:
a) The discharge is: 0 Continuous W Intermittent ❑ Seasonal*
i) If the discharge is intermittent, describe when the discharge will occur:
ii) *Check the month(s) the discharge occurs: 0 Jan ❑ Feb ❑ Mar. ❑ Apr 0 May ❑ Jun ❑ Jul
❑ Aug. ❑ Sept. ❑ Oct. ❑ Nov. ❑ Dec.
b) How many days per week is there a discharge? 11
c) Please check the days discharge occurs: ❑ Sat. ❑ Sun. on. ue. ed. u. all<..
8) Receiving stream[s]:
a) To what body or bodies of water (creek, stream, river, lake, etc.) does the facility discharge
wastewater? If the site discharges wastewater to a separate storm sewer system (4S), name the
operator of the 4S (e.g. City of Raleigh).
Page 2 of 3

NCG500000 renewal application
Additional Application Requirements:
The following information must be included in triplicate [original + 2 copies] with this application or it will
be returned as incomplete.
➢ Site map. If the discharge is not directly to a stream, the pathway to the receiving stream must
be clearly indicated. This includes tracing the pathway of a storm sewer to its discharge point.
➢ Authorization for representatives. If this application will be submitted by a consulting
engineer (or engineering firm), include documentation from the Permittee showing that the
consultant submitting the application has been designated an Authorized Representative of the
applicant.
Certification
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing:
Title: U�
(Signature of
North Carolina General Statute -215.6 b (i) provides that:
�v
I(DadSigned)
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan or other document
filed or required to be maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article, or who
falsifies, tampers with or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under
Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by
a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine
of not more than $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
This Notice of Renewal Intent does NOT require a separate fee.
The permitted facility already pays an annual fee for coverage under NCG500000.
Mail the original and two copies of the entire package to:
Mr. Charles H. Weaver
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Page 3 of 3

#099
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State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Alan W. Klimek, P.E. Director
July 26, 2002
SAM CANNADY
GREYSTONE CONCRETE PRODUCTS
PO BOX 680
BENDERSON, NC 27536
LT. MWA
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissue - NPDES Wastewater Discharge Permit
Greystone Concrete Products
COC Number NCG500312
Vance County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG500000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued wastewater general permit Certificate of Coverage
(COC). This COC is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection Agency,
dated May 9,1994 (or as subsquently amended).
The following information is included with your permit package:
* A copy of the Certificate of Coverage for your treatment facility
* A copy of General Wastewater Discharge Permit NCG500000
* A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG500000
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law rule, standard, ordinance, order, judgment, or
decree.
If you have any questions regarding this permit package please contact Aisha Lau of the Central Office Stormwater
and General Permits Unit at [phone], ext. 578
Sincerely,
for Alan W. Klimek, P.E.
cc: Central Files
Stormwater & General Permits Unit Files
Raleigh Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG500000
CERTIFICATE OF COVERAGE No. NCG500312
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE AND SMLAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
is hereby authorized to discharge
GREYSTONE CONCRETE PRODUCTS
BOILER BLOWDOWN AND
COOLING TOWER BLOWDOWN
water or similar wastewater from a facility located at
GREYSTONE CONCRETE PRODUCTS
2100 N. GARNETT ST
BENDERSON
VANCE COUNTY
to receiving waters designated as a ut to Fox Reservoir, a class C NSW water, in the Tar - Pamlico River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II,
III, and IV of General Permit No. NCG500000 as attached.
This certificate of coverage shall become effective August 1, 2002.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 26, 2002.
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Sam Cannady
Greystone Concrete Products
P.O. Box 680
Henderson, NC 27536
Dear Permittee:
ir
A&4
IDEHNFi
July 24, 1997
Subject: Certificate of Coverage No. NCG500312
Renewal of General Permit
Greystone Concrete Products
Vance County
In accordance with your application for renewal of the subject Certificate of Coverage, the Division is forwarding
the enclosed General Permit. This renewal is valid until July 31, 2002. This permit is issued pursuant to the
requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U.S. Environmental Protection Agency dated December 6,1983. If any parts, measurement
frequencies or sampling requirements contained in this permit are unacceptable to you, you have the right to request
an individual permit by submitting an individual permit application. Unless such demand is made, this certificate
of coverage shall be final and binding.
The Certificate of Coverage for your facility is not transferable except after notice to the Division. Use the enclosed
Permit Name/Ownership Change form to notify the Division if you sell or otherwise transfer ownership of the
subject facility. The Division may require modification or revocation and reissuance of the Certificate of Coverage.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the Regional
Office listed below at [phone]. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, the Division of Land Resources, Coastal Area Management Act or any other Federal or Local
governmental permit that may be required.
If you have any questions concerning this permit, please contact the NPDES Group at the address below.
Sincerely,
p"✓ A. Preston Howard, Jr., P.E.
cc: Central Files d
Raleigh Regional Office
NPDES File
Facility Assessment Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 [phone] FAX [phone] p&e®dem.ehnr.state.nc.us
An Equal Opportunity Affirmative Action Employer 50% recycled / 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG500000
CERTIFICATE OF COVERAGE NO. NCG500312
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER
BLOWDOWN, CONDENSATE, EXEMPT STORMWATER, COOLING WATERS ASSOCIATED WITH
HYDROELECTRIC OPERATIONS, AND SI IILIAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended,
Greystone Concrete Products
is hereby authorized to discharge
boiler blowdown, cooling tower blowdown and other similar wastewaters
from a facility located at
Greystone Concrete Products
2100 North Garnett Street
Henderson
Vance County
to receiving waters designated as subbasin 30302 in the Tar River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV of General Permit No. NCG500000 as attached.
This certificate of coverage shall become effective August 1, 1997.
This certificate of coverage shall remain in effect for the duration of the General Permit.
Signed this day July 24,1997.
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental
Management Commission

eezas INVOICE FOR RENEWAL OF
NPDES PERMIT
Check here if you do NOT wish to renew this permit.
Please return this page along with a letter documenting your reasons
for not requesting renewal to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 29535
Raleigh, North Carolina 27626-0535
Check here if you wish to renew this permit.
Please verify that the following information is documented accurately:
FM
5KRZINC MILL ROA
D 28655OMp,1 '/
Fax number: Az; mu
u
e-mail address:
Facility Location
DXANTO
DION
1ILL ROAD
M 28655
January 28,1997
1y66 60
No revision required.
rV� Revision required. (Please specify below.)
No revision required.
dRevision required. (Please specify below.)
Please return this page with your letter requesting renewal, and $400 fee (payable to NCDEHNR) to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 29535
Raleigh, North Carolina 27626-0535
Signature of applicant or authorized representative
Date

GREYSTONE CONCRETE PRODUCTS, INC.
P.O. Boa 680 - Phone [phone] - FAX No.1.919.438.2350
Henderson, North Carolina 27536
February 5, 1997
Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
P. O. Box 29535
Raleigh, N. C. 27626-0535
JOHN P. CANNADY, III, President
ERNESTINE C. CANNADY, Vice-Pres.
SAMUEL H. CANNADY, Sec.-Treas.
Re: Application for Renewal of NPDES
Permit number NCG500312
Dear Mr. Weaver:
Please renew our NPDES Certificate of Coverage No. NOG500312 as soon as possible.
Enclosed you will find a completed copy of the renewal invoice form, a chemical
additives list and payment in the amount of $400.00 to cover the cost of the
processing fee.
If any additional information is needed, please contact Sam Cannady at telephone
number [phone].
very truly yours,
GREYSTONE CONCRETE
Samuel H. Cannady
Secretary -Treasurer
SHC:sj
Enclosures

GREYSTONE CONCRETE PRODUCTS, INC.
P.O. Box 680 - Phone [phone] - FAX No.1.919-438.2350
Henderson, North Carolina 27536
February 5, 1997
JOHN F. CANNADY, III, President
ERNESTINE C. CANNADY, Vice-Pres.
SAMUEL H. CANNADY, Sec.-Treas.
CHEMICAL ADDITIVES LIST FOR CERTIFICATE OF COVERAGE NUMBER NCG500312
The following chemicals are used to control or inhibit scaling, corrosion and PH
balance in steam boilers:
Additive 1: BL-130 Boiler Water Treatment
Additive 2: BL-402S Boiler Water Treatment
Additive 3: BL-170CW Boiler Water Treatment
Manufactured by:
Precision Industrial Laboratories
2190 DeFoor Hills Rd., N.W.
Atlanta, Ga. 30318
Telephone: [phone]

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
August 23,1996
Mr. Sam Cannady
Greystone Concrete Products
P.O. Box 680
Henderson, North Carolina 27536
A��
[DEHNR
Subject: General Permit No. NCG500000
Greystone Concrete Products
Certificate of Coverage NCG500312
Vance County
Dear Mr. Cannady:
In accordance with your application for discharge permit received on November 6, 1995 we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general
permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
December 6,1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to vou, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Environmental Management. The Division of Environmental Management may require modification
or revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Environmental Management or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Mack Wiggins at telephone number
[phone], extension 542.
Sincerely,
Original Signed By
David k Goodrich
A. Preston Howard, Jr., P. E.
cc: Central Files
Raleigh Regional Office
Permits and Engineering Unit
Facilitv Assessment Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled / 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
TO DISCHARGE NON -CONTACT COOLING WATER, COOLING TOWER AND BOILER BLOWDOWN,
CONDENSATE AND SIMILAR WASTEWATERS UNDER THE
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
Greystone Concrete Products
is hereby authorized to construct and operate or continue operation of a treatment system for the generation of non -
contact cooling waters, boiler water blowdown or similar waste streams with the discharge of treated wastewater from
a facility located at
Greystone Concrete Products
on US Highway 1 North
North Henderson
Vance County
to receiving waters designated as an unnammed tributary to Fox Reservoir in the Tar Pamlico River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I.
II, III
and IV of General Permit No. NCG500000 as attached
This certificate of coverage shall become effective August 23,1996
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 23,1996
Original Signed By
Pavid A. Goodrich
A. Preston Howard, Jr., P.E.,Director
Division of Water Quality
By Autbarity of the Environmental Management Commission

--
ROAD CLASSIFICATION
PRIMARY HIGHWAY UGHT•DUTY ROAD, HARD OR
HARD SURFACE IMPROVED SURFACE
SECONDARY HIGHWAY
HARD SURFACE C=30M= UNIMPROVED ROAD
1-atitude:36°20'45" Longitude:78023'18"
Map # B25SW Sub -basin 03-03-02
Stream Class C NSW
Discharge Cooling / Boiler Blowdown
Receiving Stream UT to Fox Reservoir
Permit exp. 07/31/97 Ow 30 GPD
SCALE 1:24 000
0 1 MILE
p =1 111111111I7000 FEET
1 0 1 KILOMETER
CONTOUR INTERVAL 40 FEET
QUAD LOCATION Greystone Concrete products
NCG500312
Vance County
i

To: Permits and Engineering Unit
Water Quality Section
Attention: Mack Wiggins
Date August 5, 1996
NPDES STAFF REPORT AND RECOMMENDATION
County Vance
Permit No. NCG500312
PART I - GENERAL INFORMATION
1. Facility and Address: Greystone Concrete Products
P.O. Box 680
Henderson, N.C. 27536
2. Date of Investigation: August 1, 1996
3. Report Prepared by: Buster Towell, Environmental Tech.
4. Persons Contacted and Telephone Number: Sam Cannady
919-438-5144
5. Directions to Site: U.S. Hwy. 1 North in Henderson.
6. Discharge Point(s),List all Discharge points:
Latitude: 36o 20' 45" Longitude:78 o23' 18"
Attach a USGS map extract and indicate treatment facility
site and discharge point on map.
U.S.G.S. Quad No. B 25 SW U.S.G.S. Quad Name Henderson
7. Site size and expansion area consistent with application ?
_XX Yes No If No, explain:
8. Topography (relationship to flood plain included): Flat
9. Location of nearest dwelling: 200 feet
10. Receiving stream or affected surface waters:ut to Fox
Reservoir.
a. Classification: C NSW
b. River Basin and Subbasin No.: Tar -Pam \ 03-03-02
C. Describe receiving stream features and pertinent
downstream uses: Fishing, Swimming, Water Supply

ii - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Volume of Wastewater to be permitted: 30 gpd
MGD(Ultimate Design Capacity)
b. What is the current permitted capacity of the Waste
Water Treatment facility? 30 gpd
C. Actual treatment capacity of the current facility
(current design capacity)? 30 gpd
d. Date(s) and construction activities allowed by previous
Authorization to Construct issued in the previous two
years:Na
e. Please provide a description of existing or
substantially constructed wastewater treatment
facilities:
Boiler blow down into small concrete holding tank then
discharge line.
f. Please provide a description of proposed wastewater
treatment facilities:same as above
g. Possible toxic impacts to surface waters:NA
h. Pretreatment Program (POTWs only):NA
in development approved
should be required not needed
2. Residuals handling and utilization/disposal scheme:
a. If residuals are being land applied, please specify DEM
permit no.
Residual Contractor
Telephone No.
b. Residuals stabilization: PSRP
PFRP Other
c. Landfill:
d. Other disposal/utilization scheme (Specify):
3. Treatment plant classification (attach completed rating
sheet):Class I by definition.
4. SIC Code(s):3271
Wastewater Code(s) of actual wastewater, not particular
facilities i.e.., non -contact cooling water discharge from a
metal plating company would be 14, not 56.
Primary 0 Secondary
Main Treatment Unit Code: 14

it - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant
Funds or are any public monies involved. (municipal only)?
2. Special monitoring or limitations (including toxicity)
requests:None
3. Important SOC, JOC or Compliance Schedule dates: (Please
indicate)
Submission of Plans and Specifications Date
Begin Construction
Complete Construction
4. Alternative Analysis Evaluation: Has the facility evaluated
all of the non -discharge options available. Please provide
regional perspective for each option evaluated.
Spray Irrigation:
Connection to Regional Sewer System:
Subsurface:
Other disposal options: No alternatives available
5. Other Special Items:None
PART IV - EVALUATION AND RECOMMENDATIONS
The system that currently serves this facility meets the
requirements for the N.C. General Permit category 50000. The
waste treatment systems consists of a concrete holdings tank that
discharges cooling water from a boiler blow down from the
manufacture of concrete block. The Raleigh Regional Office
recommends the issuance of the COC.
A 1/4 -
Signature of report preparer
Water Quality Regional Supervisor
Date

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ROAD CLASSIFICATION
PRIMARY HIGHWAY LIGHT -DUTY ROAD, HARD OR
HARD SURFACE IMPROVED SURFACE
SECONDARY HIGHWAY
HARD SURFACE =31111111111111111=1 UNIMPROVED ROAD
Latitudei36°20'4511Longitude:78°23118g'
Map # B25SW Sub -basin 03-03-02
Stream Class C NSW
Discharge Cooling / Boiler Bow own
Receiving Stream UT to _Fox Reservoir
Permit exp. 07/31 /97 Qw 30 GPD
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SCALE 1:24 000
QUAD LOCATION Greystone Concrete products
NCG500312
Vance County
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